Journal Article

Results from the Survey of Antibiotic Resistance (SOAR) 2011–13 in the Gulf States

A. Jamsheer, A. M. Rafay, Z. Daoud, I. Morrissey and D. Torumkuney

in Journal of Antimicrobial Chemotherapy

Volume 71, issue suppl_1, pages i45-i61
Published in print May 2016 | ISSN: 0305-7453
Published online April 2016 | e-ISSN: 1460-2091 | DOI: https://dx.doi.org/10.1093/jac/dkw064
Results from the Survey of Antibiotic Resistance (SOAR) 2011–13 in the Gulf States

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  • Medical Oncology
  • Critical Care

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Objectives

To provide surveillance data on the susceptibility of community-acquired respiratory tract isolates from four Gulf and Near East countries from 2011 to 2013.

Methods

MICs were determined using Etests® for all antibiotics evaluated except erythromycin, where testing was by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.

Results

Seven hundred and twenty-six respiratory isolates comprising 265 isolates of Streptococcus pneumoniae, 125 isolates of Streptococcus pyogenes and 336 isolates of Haemophilus influenzae were collected from Bahrain, Lebanon, Oman and the United Arab Emirates (UAE). Among S. pneumoniae, susceptibility to penicillin was low in the UAE and Bahrain. Macrolide susceptibility was ∼45%–60% in the UAE and Oman but higher in Lebanon (73.7%) and Bahrain (84%–85%). Penicillin susceptibility using CLSI intravenous breakpoints was >85% in all countries. Antibiotic susceptibility of S. pneumoniae was lower in UAE and Oman. Among S. pyogenes isolates, resistance to erythromycin was highest in Oman (31.6%) but <20% in the other countries. In H. influenzae, susceptibility to most antibiotics was high, except for ampicillin in Lebanon (70.2%) and amoxicillin in Oman (95.4%). Lebanon also had a high percentage (14.9%) of β-lactamase-positive isolates with non-susceptibility to ampicillin. Amoxicillin/clavulanic acid susceptibility was >95% in all countries. Use of EUCAST versus CLSI breakpoints demonstrated profound differences for cefaclor and cefuroxime in S. pneumoniae and H. influenzae, with EUCAST showing lower susceptibility.

Conclusions

There was considerable variability in susceptibility among countries in the same region. Thus, continued surveillance is necessary to track future changes in antibiotic resistance.

Journal Article.  11495 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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